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Opioid treatment access would be expanded under House Democratic bill

Users in treatment would be able to continue to get methadone prescriptions from pharmacies to take at home.
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WASHINGTON — Rep. Donald Norcross, D-N.J., and Sen. Ed Markey, D-Mass., announced legislation Monday that would allow some opioid users in treatment to continue to get methadone prescriptions from pharmacies to take at home, making the easing of restrictions approved during the coronavirus pandemic permanent.

The Opioid Treatment Access Act targets restrictions on methadone, a leading medication to treat a condition called opioid use disorder. The restrictions could return late next year when the take-home flexibility measures are set to expire. Before the pandemic, patients had to make daily trips to clinics to get single doses of the addiction medication.

“We have to treat them like any other injury or disease and give them the dignity of accessible treatment,” Norcross said. "Imagine being in recovery and trying to get a job and saying, 'Excuse me, each day I need to go pick up my methadone.'"

Drug overdose deaths hit a record high during the pandemic, at more than 100,000 nationally in the 12 months that ended in April, compared to 78,000 reported in the previous year, according to provisional data from the National Center for Health Statistics. Of those deaths, 93 percent were in connection with opioid use.

It is first time overdose deaths, which have doubled since 2015, have eclipsed 100,000 a year.

Markey is introducing the companion bill in the Senate. He was instrumental in pushing for expanded access to treatment during the pandemic.

Opioid abuse “is a crisis that has gone under the radar because of the Covid pandemic,” Markey said in a telephone interview. “It has never been more important to modernize and expand how patients receive opioid treatment.”

When the pandemic first emerged last year, the Substance Abuse and Mental Health Services Administration, or SAMHSA, allowed opioid treatment programs to dispense 28 days of take-home methadone doses to stable patients to treat opioid use disorder and 14-day doses for less stable patients whom opioid treatment programs have determined can safely handle take-home medication.

The exception was issued to safeguard public health by reducing the risk of Covid-19 infections among patients and health care workers, SAMHSA said.

More than a year after the program began, preliminary studies found that the increase in take-home methadone doses has enhanced patients’ satisfaction and engagement with treatment, while incidents of misuse have been relatively low.

“We’ve seen preliminary data that when access to lifesaving medication is more available, overdose deaths go down,” said Dr. Kaitlan Baston, the division head of addiction medicine at Cooper University Health Care in Camden, New Jersey. “This is a daily medication, and skipping one day can be devastating for a patient.”

Critics say take-home flexibility has made it easier for people to get methadone and encouraged opioid abuse.

SAMHSA announced an extension of the exemption for one year in November, until late 2022, saying it would also consider mechanisms to make the flexibility permanent. The move was in line with the Department of Health and Human Services’ recently announced overdose prevention strategy, SAMHSA said.

The extension is effective only upon the expiration of the Covid-19 public health emergency.

Norcross said his legislation would reduce the stigma around methadone treatment and enforce greater collection of data about methadone use — to enable medical professionals to assess its effectiveness — and allow patients to use telehealth services to track their treatment plans.

CORRECTION (Dec. 6, 2021, 9:50 p.m. ET): A previous version of this article misspelled the first name of a doctor at Cooper University Health Care. She is Kaitlan Baston, not Kaitlin.